It is often difficult to complete a standard therapeutic course in patients with cancer associated with alcoholism. As such patients cannot understand their cancer and treatments, physicians have to convince them to receive medical care in cooperation with their family or psychiatrist. We describe our experience of treating a patient with carcinoma of the floor of the mouth complicated by alcoholism-related malnutrition. A 49-year-old male patient was referred to our hospital with a chief complaint of a tumor of the right floor of the mouth. Results of a biopsy indicated squamous cell carcinoma （T2N1M0, stage Ⅲ）. We subsequently administered S-1 chemotherapy in accordance with the patient’s preference. Thirteen months after initiation therapy, he arrived by ambulance with disturbed consciousness. We immediately administered thiamine intravenously, and implemented nutrition control and treatment for electrolyte disorders. However, his neurologic condition, which included a memory disorder and abnormal behavior, continued, and he was diagnosed as having Wernicke-Korsakoff syndrome. His symptoms improved following continued thiamine supplementation and psychiatric treatment, and then he underwent surgical resection of the carcinoma of the floor of the mouth. He had no recurrence or metastasis of the carcinoma, and he died of another disease 2 years and 3 months later.

View full abstract